Individual provider Active NPI

Laura Davidson, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • South Kingstown, RI
National Provider Identifier
1003105073
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN02027 Issued in RI
Practice address
65 Village Square Dr Ste 302
South Kingstown, RI 02879-2569
Phone
(401) 785-0040
Fax
(401) 633-6253
NPI assigned
Mar 30, 2011
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN02027 RI Primary

Addresses

Primary practice location

65 Village Square Dr Ste 302
South Kingstown, RI 02879-2569

Mailing address

65 Village Square Dr Ste 302
South Kingstown, RI 02879-2569
Phone (401) 785-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190426001505 RI Practitioner - Certified Clinical Nurse Specialist (CNS) 5193902971 Reassigns benefits to 1 organization
I20240701003908 RI Practitioner - Nurse Practitioner 5193902971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Child and Family Psychiatry, Inc.Group PAC ID 5294173464, 90 clinicians

Practice addresses (Care Compare)

65 Village Square Dr
Suite 302
South Kingstown, RI 02879-2569
Phone (401) 785-0040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN02027RIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thundermist Health Center CurrentSince Apr 1, 2019 Accepting new patients
Thundermist Health Center CurrentSince Apr 1, 2019 Accepting new patients
Child and Family Psychiatry, Inc. CurrentSince Jun 1, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

65 Village Square Dr
Ste 302
South Kingstown, RI 02879

1 River St
Wakefield, RI 02879
Phone (401) 783-0523

1035 Post Rd
Warwick, RI 02888
Phone (401) 941-2830

25 John a Cummings Way
Ste 302
Woonsocket, RI 02895

450 Clinton St
Woonsocket, RI 02895

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA
  • Direct secure messaging: lifestancehealth.lauradavidson@151046.advancedmd-direct.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1003105073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 VILLAGE SQUARE DR STE 302",
            "city": "SOUTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028792569",
            "telephone_number": "401-785-0040",
            "fax_number": "401-633-6253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 VILLAGE SQUARE DR STE 302",
            "city": "SOUTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028792569",
            "telephone_number": "401-785-0040",
            "fax_number": "401-633-6253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "LAURA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-30",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "APRN02027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Kingstown, RI

Sources for this page

Verify at the official NPI Registry.